Accident Detail Receipt
Date And Time 04-Jun-2018 / 9:30 am
Place of Accident shahada to shirpur road karmvir petrol pump frunt
CR NO/ TAR No/ SDE NO shirpur city ps cr no 145/2018 ipc 304 a, 279, 337, 338, 427 m v act 184, 134/177
Name of the Injured/ Deceased 1) kamalbai pandharinath koli, 2) ajay ravindra koli add. waghadi tal shirpur dist dhule
Name of The Hospital to which he/she was removed cottage hospital shirpur siddeshwar hospital dhule bhausaheb hire medical collage dhule
Number of vehicle and type of the vehicle mh 18 ab 0603, mh 19 ad 7662
Name of address of driver of the vehicle with perticuler ordriving license of the said driver and the address of the issuing Authority of the said driver license. The number of badge in case of public service vehicle and the address of the issuing Authority of the said badge. shaikh haidar shaikh gaffur age 40 add. ganesh colony shirpur RTO DHULE lic.no. MH18200110027243 valid. 31/05/2027
Name of the owner of the vehicle as it stand on the date of the accident harun beg sikandar beg add. shirpur
Name and address of the insurance company with whom the vehicle was insured and the divisional office of the said insurance Company. ..
Number of Insurance Policy/Insurance Certificate and the Date of the validity of the insurance Policy /Insurance Certificate ..
Action Taken if any, and the result thereof. investigation proceed

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